What
is impairment?

Impairment is a
condition that results from the use of mind/mood altering substances, distorted
thought processes found in the psychologically impaired or a physical condition
that prevents the nurse from providing safe patient care. Impairment is characterized
by the inability to carry out the professional duties and responsibilities in
a reasonable manner consistent with nursing standards. This guide will focus only
on impairment caused by chemical dependency.

There is no resolution of
problems associated with chemical dependency without effective intervention or
treatment. Coworkers often feel frustrated and helpless. Staff morale may deteriorate
while the chemically impaired nurse becomes more impaired. As chemical dependency
progresses, the potential for compromising patient care increases. Cognitive functioning,
decision-making, reaction time, judgment and the ability to handle stress are
increasingly affected.

Who
may make a report to the Intervention Project for Nurses (IPN)?

Any
person suspecting impairment of a nurse’s ability to provide safe nursing care
may report this nurse to IPN and/or the DOH. Under Florida’s Mandatory Reporting
Law, all licensed nurses must report any suspected impairment in practice to IPN
and/or the DOH.

Will
participation in the Intervention Project for Nurses (IPN) protect my nursing
license from discipline by the Florida Board of Nursing?

Being
unable to practice nursing safely due to use of drugs, alcohol, chemicals, a mental
condition, or the possession or distribution of controlled drugs for other than
legitimate purposes is a violation of the Nurse Practice Act that can result in
disciplinary action taken against a nurse’s license by the Florida Board of Nursing.
If the nurse has been reported only to IPN, he/she agrees to participate in IPN,
and successfully completes IPN, the file is closed and held in confidence
with no disciplinary action resulting. If the nurse is reported only
to IPN, and does not agree to participate, or does not successfully complete IPN,
then the information in IPN’s possession is forwarded to the DOH, and may result
in disciplinary action, if deemed appropriate. In some cases, the nurse
is reported both to IPN and the DOH and in those cases, the disciplinary process
proceeds and may result in disciplinary action.

What are some of the signs and symptoms to look for that may indicate a nurse
is experiencing problems with chemical dependency or other conditions that may
impair his/her ability to provide safe nursing care?

While
the following is not intended as a complete list, they include increases in absenteeism,
which may be more pronounced following scheduled days off, subtle changes in appearance
and/or behaviors that escalate in severity over time, as well as decreasing competence
in patient care. The usually quiet nurse may become talkative and gregarious,
or the reverse may occur, where the nurse becomes isolated and withdrawn from
peers who were once professional or social contacts. The nurse may overreact verbally,
snapping at colleagues, or become disproportionately angry or emotional in response
to situations that were handled appropriately or calmly in the past.

Will
a nurse still be able to practice nursing while participating in the Intervention
Project for Nurses (IPN)?

Initially,
the nurse may be required to refrain from nursing practice during the evaluation
phase and any resulting treatment. The nurse may resume nursing practice when
given authorization to do so by IPN. The approval for a return to nursing practice
is based upon recommendations from approved treatment providers in consultation
with IPN staff. Practice limitations are often required during the early phase
of return to practice.

Why
should a nurse choose to participate in IPN?

The
IPN staff can assist the nurse in obtaining appropriate treatment, continuing
care, and ongoing support. If the nurse has violated the Nurse Practice Act, IPN
participation is an alternative to disciplinary action by the Florida Board of
Nursing. If the nurse is already involved in the disciplinary action process through
the DOH, an IPN representative will be present. When that nurse’s case is heard
before the Florida Board of Nursing, IPN can confirm that the nurse is engaged
in the recovery process.

Does
IPN provide evaluation and/or treatment for nurses?

IPN
does not provide the evaluation and/or treatment required, but does provide referrals
to Board-approved Addictionist, Psychiatrist, and/or other treatment professionals.
These Addictionists, Psychiatrists, and/or treatment providers are located throughout
the State of Florida and referrals will be made to a provider geographically closest
to the nurse's place of residence.

What
are the costs/fees for IPN participation?

Unlike
some of the other professional alternative to discipline programs, IPN does not
charge a fee for participation. The nurse is responsible to pay for the cost of
all evaluations and/or treatment that may be required. For those nurses who are
required to submit to random drug testing, they are responsible for the cost of
all laboratory testing that is performed.